| Woodlands Elite Dental Partners, Pllc | |
|
25300 Borough Park Dr Spring TX 77380-3552 | |
| (281) 296-0052 | |
| (281) 296-0118 |
| Full Name | Woodlands Elite Dental Partners, Pllc |
|---|---|
| Speciality | Dentist |
| Location | 25300 Borough Park Dr, Spring, Texas |
| Authorized Official Name and Position | Dea Ann Kipp (DIR. OPERATIONS/PROFESIONAL RELATIO) |
| Authorized Official Contact | 2812968600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Woodlands Elite Dental Partners, Pllc 26615 Oak Ridge Dr The Woodlands TX 77380-1968 Ph: (281) 296-8600 | Woodlands Elite Dental Partners, Pllc 25300 Borough Park Dr Spring TX 77380-3552 Ph: (281) 296-0052 |
| NPI Number | 1407969009 |
|---|---|
| Provider Enumeration Date | 08/16/2006 |
| Last Update Date | 06/19/2023 |
| Medicare PECOS PAC ID | 3779020912 |
|---|---|
| Medicare Enrollment ID | O20250206002878 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407969009 | NPI | - | NPPES |
| 163478401 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Arthur James Johnson |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1972866218 PECOS PAC ID: 4688111826 Enrollment ID: I20250206002997 |
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